Proposed DSM-V gets it wrong?

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“A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: . . . ” [Emphasis added.]
http://www.dsm5.org/ProposedRevisions/P ... px?rid=94#

Wow. I thought one of the defining characteristics of autism is that it is developmental. Offhand, I’d say these authors are so worried about the formality of the writing that they are getting the content wrong.

And yet another example, that if we need it, that we can’t really count on professionals. They can do maybe 30% of it. They are welcome to help out. But the remaining 70% needs to be us. So we learn from the Civil Rights Movement and other movements for social change. And we consider possibilities for social activism, and move forward (medium steps) with what feels right.

I think the point is that a person who is developmentally delayed is not necessarily autistic. Autism isn't defined by GENERAL developmental delays, it is defined by developmental delays in certain areas.

Yes, I agree with that. People with pervasive development delay disorders are not in the "general" category, and vice versa.

Yes, this sounds reasonable. A person can be developmentally delayed for reasons other than autism.

Now, on this one, I thought there was considerable overlap between pervasive development delay and autism spectrum.

And I'd like to get more play out of the idea that we can do for ourselves.

We can think for ourselves, feel for ourselves, act for ourselves.

PDD is just another way of saying autism spectrum.

General developmental delays means intellectual disability, which is not autism.

However, in common language "pervasive" and "general" means very similar things, I think



Perhaps it is the problem of the euphemisms ("pervasive development disorder" instead of "autism" and "general development disorder" instead of "mental retardation")

I am in favor of being polite and focusing on the positive, that is, on focusing on what the person can do. I don't know if that's the same as euphemism and political correctness.

I do think the very formality of the language is part of the problem in the field of psychology.

http://www.dsm5.org/ProposedRevisions/P ... px?rid=94#
A. " . . . by all 3 of the following . . . "
1. " . . . reciprocity . . .
2. " . . . nonverbal . . .
3. " . . . developing and maintaining relationships . . . "

It’s a lot of verbiage to say not very much. I mean, when the sentences are so dense with phrases that you’re not sure what’s the subject and what’s the verb, that’s a problem!

Now, we can puzzle it out, for we are smart people. And we might do this almost as a hobby or an intellectual puzzle, but it’s probably not the best expenditure of our time overall.

In subsection 2 we also have " . . . nonverbal . . . through abnormalities in eye contact and body-language . . . " That’s just a fancy way of saying "normal" is good and "non-normal" is bad. (No such thing as really normal! Every human being on the face of the Earth is non-normal in his or her own way.)

Then you get to the end of the whole thing:
"D. Symptoms together limit and impair everyday functioning."

Wow, that’s the heart of the matter. And there’s just not very much meat to that. It just is not particularly helpful.

Currently an Aspergers Diagnosis requires a criteria of no general developmental delay.

In their attempt to provide one diagnosis to cover those currently diagnosed with PDD NOS, Aspergers, childhood disintegrative disorder, and Autism; by creating one Autism Spectrum Disorder, leaving the requirement for general developmental delay, as it is it is required in the DSM IV for Autism, would exclude people currently diagnosed with Aspergers of being diagnosed in the new DSM V proposed revision that covers all four disorders.

The common element between PDD NOS, Aspergers, Childhood Disintegrative disorder and Autism is persistent difficulties in social communication and social interaction. They are already a required criteria in the DSM IV for all four disorders.

The people that wrote the DSM V revision believe it is likely that those currently diagnosed by the criteria set forth with the DSM IV, with any of these four disorders, will meet the required criteria in the DSM V.

There is no mention of a requirement for a re-diagnosis for those currently diagnosed with the four disorders once the proposed DSM V revision is finalized, and put into effect.

I'll go with that as getting more to the heart of the matter. And as I've said before, good-hearted professionals can help out, but we should not allow them to run the show nor expect them to. Most of it needs to be self-help and self-advocacy generally in line with the civil rights movement (which besides the big dramatic marches had a lot of everyday work behind the scenes).

For me, Asperger's / Autism Spectrum means patchy social skills. And in previous relationships, because I have good skills in some areas, a friend or girlfriend might think something is deliberate, and it's just not. Next relationship, I think I'm just going to ask "Are you hip to someone being aspie?" In fact, I'm kind of looking forward to it.

For some people, stimming is part of how they integrate their internal world and sensory input. Yes, it's embarrassing, but I think parents often make it worse by making too big a deal out of it. (I stim, too, with soft T-shirt, but kind of do it privately.)

And overall, yes, we can use the formal definition for what it's worth. But really, I got a heck of a lot more out of Tim Page's book Parallel Play.

As far as I know PDD and ASD are currently synonymous. Whether or not they should be, they are right now, so when I used the term PDD, I was referring to those development delays on the autistic spectrum.

I should be more specific. The general developmental delays that separate Aspergers from Autism are clinically significant delays in language, cognitive development, and adaptive functioning. As defined, currently, in the DSMIV

In the DSMV they are proposing to eliminate these developmental delays as criteria for the diagnosis of Autism that differentiate Autism from Aspergers.

Instead, they focus on the commonality of features between the four disorders such as deficits in social communication and social interaction.


Referenced link may provide a better explanation than I can. It also provides insight into some of the controversy associated with the proposed changes.


http://www.child-psych.org/2010/02/autism-and-aspergers-in-the-dsm-v-going-beyond-the-politics.html

“As simple background, according to the DSM-IV, the basic diagnostic distinction between autism and Asperger’s disorder is absence of clinically significant delays in language, cognitive development, and adaptive functioning in the Asperger’s group. . . . Therefore, two teens with otherwise identical clinical profiles would be diagnosed differently if they differ on their history of language and cognitive delays. The child with a history of language/cognitive delays would be diagnosed with HFA and the child without a history of language/cognitive delays would be diagnosed with Aspeger’s.” [Boldface repeated just as in original]
http://www.child-psych.org/2010/02/auti ... itics.html

So, that is the current way. The new proposed DSM-V is to de-emphasize language/cognitive delay as important.